First few Article Sentences
One of the biggest high-wire acts for hospital administrators and executives today is ensuring that the clinical documentation supports the services coded and billed. Why is this important? Because, to put it simply, Medicare revenue retention is directly tied to hospitals’ clinical documentation quality and coding accuracy.
The permanent Medicare Recovery Audit Contractor (RAC) program was rolled out throughout the nation in January 2010. Since then, most hospitals have experienced automated and complex reviews pertaining to suspected coding and billing errors. In August 2010 three of the four RAC contractors received Centers for Medicare & Medicaid Services (CMS) approval to review as many as 29 Medicare Severity Diagnosis Related Groups (MS-DRGs) for medical necessity.